On May 12, 2020, the Pennsylvania Department of Health (“DOH”) released new guidance announcing a universal testing strategy for Skilled Nursing Facilities in the state intended to help prevent and control infection in long-term care facilities. According to the COVID-19 Data published on the Pennsylvania DOH website, residents and staff of nursing homes and personal care homes account for roughly 25% of the state’s total COVID-19 cases and 69% of the state’s COVID-19 related deaths.
The universal testing strategy guidance was released to nursing homes and long-term care facilities across the state on the same day that the DOH issued Interim Guidance for Skilled Nursing Facilities and Hospitals requiring the testing of any resident being discharged from a hospital to a nursing home, personal care home or assisted living facility, if they were not hospitalized due to COVID-19.
Despite Secretary of Health Dr. Rachel Levine’s earlier concerns that there were not enough tests available to test everyone in nursing homes, Pennsylvania health officials now seem committed to testing all residents and staff in long-term care facilities throughout the state. It is important to note that the DOH does not mandate universal testing of all nursing home residents and staff at this time. Rather, the guidance states that testing in nursing homes “should be implemented in addition to existing infection prevention and control measures recommended by the DOH, including visitor restriction, cessation of communal dining and group activities, monitoring all healthcare personnel (“HCP”) and residents for signs and symptoms of COVID-19.”
There are over 700 nursing homes and long-term care facilities in the state with more than 80,000 residents. Given the limited availability of testing, it would be incredibly difficult, if not impossible, for the nursing homes and long-term care facilities in the state to comply with a mandatory testing requirement for all residents and staff at this point, especially since each negative test should be followed with a second test within 24 to 72 hours later to confirm the results. Therefore, the guidance recommends aligning testing strategies in consideration of testing capacity and prioritizing testing of units with symptomatic residents if testing of all residents is not possible for facilities with suspected or confirmed cases. For facilities with no known cases, the guidance recommends testing 20% of residents each week and moving to a facility-wide testing strategy should there be any positive tests from the sample population.
The coronavirus pandemic has hit long-term care facilities especially hard and a number of states have been working to institute universal testing mandates for all residents and staff. In the past couple of weeks states including Arizona, Delaware, South Dakota, Texas, West Virginia, and New Jersey have all announced universal testing initiatives for long-term care facilities. (Read more about New Jersey’s universal testing efforts here).